Cannabis Addiction: All You Need to Know

As of November 2018, cannabis has been legalized in 10 U.S. states as well as the District of Columbia (Washington, D.C.). It’s been cleared for medical use in 36 states. Canada even legalized it on a federal level in 2018. How does a drug that is considered as a Schedule I drug by the Drug Enforcement Administration get such overwhelming support across the world? Is it that marijuana isn’t as bad as we previously thought?

One of the main reasons for legalizing cannabis has been its effect on our penal system and the cause of much racial bias. There’s also the toxicity of the matter to consider. It’s practically impossible to overdose on cannabis, and it’s impossible to become addicted to. Right?

Maybe.

Marijuana’s health benefits have been touted over the past few years. It’s been showing up in beauty products, health treatments — and it’s even made an appearance on Goop. Yet what do we really know about the addictive properties of marijuana? Can you become addicted to the stuff? Are there any adverse side effects? How easy is it to quit?

What is Cannabis Addiction?

Cannabis as an addictive substance is a hotly debated topic. Many researchers believe that cannabis isn’t addictive in the way that most drugs are addictive. (Such drugs could include tobacco, alcohol and even harder drugs like cocaine and heroin.)

Yet that doesn’t mean that a person can’t abuse cannabis or even experience the symptoms of addiction. In fact, many scientists believe that cannabis can be just as addictive as harder drugs — and can even lead to the use of hard drugs. This often happens when users build up a tolerance to cannabis.

This is why cannabis addiction is often referred to as marijuana use disorder — and not as an addiction — although the National Institute on Drug Abuse (NIH) states that marijuana use disorder can sometimes take the form of addiction.

The NIH defines marijuana use disorder as occurring, “When the brain adapts to large amounts of the drug by reducing production of and sensitivity to its own endocannabinoid neurotransmitters.”

Marijuana use disorder becomes an addiction when cannabis use becomes a problem, yet the user cannot stop using it. The NIH does admit that there is a gray area regarding cannabis addiction, which is why most users who encounter problems with the drug are simply diagnosed with marijuana use disorder as opposed to addiction.

Positive and Negative Side Effects of Cannabis

We can’t talk about cannabis without mentioning some of its positive and negative side effects. Let’s face it: we all have someone in our lives who thinks cannabis is the all-natural god-given answer to everything that is bad in this world. And we all have that grumpy uncle who thinks that marijuana is for “losers” and deadbeats.

There’s just as much bias surrounding cannabis as there is commercialism these days, so we’d better look at why people are using it in the first place (and why it should be used responsibly).

Negative Side Effects of Cannabis

Let’s start with the not-so-good news. For some, cannabis can have adverse side effects. Many users complain of symptoms including paranoia, nausea and anxiety during or after consuming marijuana. The reasons for these side effects can vary.

For example, many users complain of feelings of paranoia. Yet these feelings can range from light anxiety to intense paranoid delusions. One reason many users might feel paranoid? Cannabis is illegal in most states (and on a federal level). Many users simply become paranoid because they’re breaking the law.

Your genetics and preexisting conditions can also play a role in paranoia. If you’re someone who is already prone to paranoia, you might be more likely to have a heightened sense of paranoia while consuming cannabis.

Consuming too much cannabis can also make some people nauseous or anxious. Combining cannabis with other drugs, including alcohol and prescription drugs can also increase adverse side effects.

Positive Side Effects of Cannabis

Whew. We’re glad that’s over.

Luckily, cannabis also has some pretty groovy positive side effects too. Many users report that they feel relaxed, happy, euphoric and even more creative after consuming cannabis.

In addition to the recreational uses of cannabis, many use the drug for therapeutic and medicinal purposes too.

Cancer patients have been using cannabis for years to ease the side effects of chemo and radiation. Many claim that it helps to ease anxiety and depression. Some parents are even seeking out the drug to help children who battle with seizures, epilepsy and autism.

Cannabis is even being tested as a cure for drug and alcohol addiction. A drug that might lead to addiction also curing addiction? Minds blown.

How can something be considered so good and so “bad” all at the same time? It’s no wonder that many have mixed feelings and emotions about it.

Cannabis Addiction Facts

The body doesn’t become addicted to marijuana in the same way it does when using drugs like cocaine, heroin, tobacco or caffeine.

This is why most experts don’t call it an addiction at all. It’s called marijuana use disorder. According to the NIH, some cases can turn into an addiction. Yet those cases aren’t extremely common. Some other facts you might not have known about cannabis addiction include:

Cannabis is considered a “gateway” drug, meaning its use can lead to harder drugs

Causes of Cannabis Addiction

How can some people find cannabis a “miracle drug” while others call it a “gateway drug?” Why does cannabis have positive effects on some and negative effects on others? How does one person use it to chill out and another find themselves unable to find their way out of the pantry?

How can one person use cannabis to cure their addiction to alcohol or opioids while another can find themselves chemically dependent upon it?

According to some researchers, it all comes down to genetics, preexisting conditions and usage.

Cannabis Addiction and Genes

Compared to other drugs, cannabis doesn’t necessarily have the same addictive properties. Yet there’s no dispute that some people find themselves unable to quit cannabis. They often also find their quality of life decreasing while using it, yet they are unable to stop using.

One explanation could be genetics.

The NIH reported that some twin studies have shown that nature versus nurture might not have such a huge effect on cannabis addiction. Twins who grew up in completely different social classes and environments still experienced the same issues with drug abuse.

“Our research supports other studies that indicate family and social environmental factors are influential in determining whether an individual begins using these drugs,” the NIH reported in an interview with Dr. Kendler of the Medical College of Virginia in Richmond. “But our findings suggest that the progression from the use of cocaine or marijuana to abuse or dependence was due largely to genetic factors.”

The Today Show also reported that genetics could play a huge role in healthy habits. Everything from eating habits to caffeine consumption can be passed down to your offspring.

Other Factors and Causes of Cannabis Addiction

Genetics might play a huge role in cannabis addiction, but it’s not the only cause. Many other factors can attribute to a higher risk of addiction, including mental illness, environmental stressors, tolerance levels and brain chemistry.

Mental Illnesses

A family history of mental illness can play a huge role in cannabis addiction, according to some. In an interview with Healthline in 2016, Dr. Stalcup of the New Leaf Treatment Center stated:

“Mental health is a huge risk factor for addiction. Drugs work very well, at first, for mentally ill people. If you’re anxious, it’ll go away with a couple of hits, a beer. It’s like magic. But then, the tolerance sets in. So, not only do they need to drink more to relieve the anxiety but every single time they try to stop, the underlying anxiety comes back worse. We conceptualize it as a biological trap. It works at first, it turns on you, it stops working, and then you still have a problem.”

Home and Social Stressors

Environmental stressors can also lead to dependence. Those who use cannabis for social anxiety or to “escape” their home lives, might find themselves more dependent on the drug over time.

Since cannabis addiction is genetic, it’s more likely that someone will become dependent if others in the household also use.

Increased Tolerance

One way to determine if your cannabis routine is a problem is to determine if your tolerance for the drug has increased at all.

Just like with alcohol, your body will begin building up a tolerance to help “fight” the cannabis. This means that you’ll need to begin ingesting more cannabis to get the same high you did before. When you continue to increase these levels of THC in your blood system, you’re at more of a risk of becoming dependent on it.

Brain Chemistry

Brain chemistry can also play a huge role in your likelihood of becoming addicted to cannabis. Scientists look at two factors when it comes to marijuana and brain chemistry: decreased dopamine responses and CB1 receptor downregulation.

CB1 Receptor Downregulation

“Receptors in human subjects who chronically smoke cannabis. Downregulation correlated with years of cannabis smoking and was selective to cortical brain regions. After four weeks of continuously monitored abstinence from cannabis on a secure research unit, CB1 receptor density returned to normal levels.”

Diagnosis of Cannabis Addiction

So how can you determine once and for all if cannabis is a problem for you or a loved one? There’s a fine line between medicinal, therapeutic and recreational uses and abuse.

There are several symptoms and signs that you’ll want to be on the lookout for when self-diagnosing a cannabis addiction.

Signs of Cannabis Addiction

Sometimes it’s easier to offer a diagnosis for someone else’s cannabis dependence than it is your own. Many of the signs and symptoms are behavioral and physical, and cannabis users may not notice them.

According to the NCBI, “The definition of marijuana (Cannabis) dependence (addiction) contains three critical elements. These are (a) preoccupation with the acquisition of marijuana, (b) compulsive use of marijuana, (c) relapse to or recurrent use of the marijuana.”

Preoccupation With the Acquisition of Marijuana

One of the signs of dependency is a preoccupation with marijuana. Sometimes people with a dependency tend to seek out situations where marijuana will be involved or become preoccupied with finding marijuana in different environments.

For example, users with dependency problems might choose one social setting over another because of the likelihood of taking cannabis in either situation. Or, once the person has arrived in the social setting, he or she might be preoccupied with where and when cannabis will be consumed. These users might not be able to focus until they feel certain that cannabis will be involved.

Compulsive Use of Marijuana

Many users who find themselves facing a dependency issue use marijuana compulsively. They often use it at the same time each day and reach for it when dealing with emotional issues. Many compulsive users have rituals surrounding marijuana, such as “waking and baking.”

Relapse or Recurrent Use of Marijuana

Like with any drug dependency or addiction, it’s common for those with marijuana dependency to relapse. They may have “taken a break” from marijuana or claimed they quit — only to begin using again. This often happens because the user continues to socialize with the same people (who also use marijuana frequently) and doesn’t change his or her routine to replace marijuana with other healthier behaviors.

Disregard for the Consequences of Marijuana Use

When marijuana is used responsibly, it can be a tool for relaxation or a medicine to help cure disease and disorders. Yet when marijuana is abused, there can be consequences.

Those who abuse marijuana often find themselves “slipping” in other areas of their lives. They might think everything is fine, but others can see the problem. Some of the consequences of marijuana abuse include: showing up late for work, missing social engagements, failing to pay attention to one’s health and slow motor skills.

Many users who abuse marijuana fail to recognize these consequences or they simply disregard them altogether.

Physical Signs of Marijuana Dependence

In addition to the signs of cannabis addiction, you might notice some physical symptoms. According to Addictioncenter.com, these might include:

Bloodshot eyes

Increased appetite and/or weight gain

Lack of motivation

Nervous or paranoid behavior

Impaired coordination and /or slowed reaction time

Behavioral Problems and Cannabis

Cannabis addiction can also bring with it behavioral problems and pathophysiology changes. Keeping an eye out for these behavioral changes can help diagnose someone who may be abusing marijuana.

Symptoms of Cannabis Addiction

The behavioral symptoms of cannabis addiction are often very subtle, so it’s not always easy to tell if someone has a dependence on the drug. According to the Canyon Malibu, a treatment center in California, there are 10 signs of marijuana addiction. Someone who has a dependence problem might exhibit one or more of these signs. They include:

Increased tolerance (and withdrawal symptoms)

Overuse

Inability to stop using

Spends inordinate amounts of time with or thinking about marijuana

Reduces time spent on other activities

Refuses to acknowledge the problems caused by marijuana dependence

Uses marijuana as a means of escapism

Begins depending on marijuana

Prioritizes marijuana-based activities

Can’t perform daily responsibilities

Increased Tolerance

As we stated before, increased tolerance simply means that it takes more marijuana to achieve the same state of euphoria. The body has built a tolerance to marijuana to protect its cells, and the user must now increase the dosage.

Overuse of Cannabis

The person in question may visibly overuse cannabis. Others might notice some of the physical signs of cannabis abuse (see below the section titled, ‘Physical Signs.’

Inability to Stop Using Cannabis

When the user tries to cut down or stop using, he or she relapses or goes back to using the drug.

Spends Inordinate Amounts of Time With Marijuana

Sometimes those with cannabis dependencies talk about the drug a lot or find themselves thinking about it obsessively.

Reduces Time Spent on Other Activities

People with cannabis dependencies often stop caring about hobbies and activities that once used to bring them joy — and opt instead to spend that time on cannabis.

Refuses to Acknowledge Marijuana Dependency Problems

Some users won’t see their dependency problems as “problems” until the consequences become too extreme to ignore.

Marijuana As Escapism

Escapism is one of the most common forms of marijuana abuse. Many users begin taking marijuana to relax after a long day or to self-soothe. This can become a problem when they stop facing their problems and use the drug to escape them instead.

Marijuana Dependence

Users who depend on marijuana might say things like, “I really need to smoke right now.” They might also create a routine around marijuana to help them “get through” the day.

Prioritizes Marijuana

Marijuana use should always come secondary to other activities. Healthy use of the drug might include taking a small amount to relax at the end of the day — or while socializing with friends. When marijuana becomes “the main event,” it could be a sign of dependence.

Failure to Perform Daily Responsibilities

One major red flag of marijuana abuse is failing to perform responsibilities. These might include failing to:

Sometimes these symptoms are easy to miss. Some users may also exhibit certain symptoms or signs — yet they don’t have a problem. It’s when one or more of these symptoms are present that you may want to have a conversation with the user about abuse.

Pathophysiology and Behavioral Changes

In addition to some of the above symptoms, many users will also exhibit pathophysiological changes. These include changes in behavior and mood.

According to Psychology Today, “Research shows that brain abnormalities are linked with chronic pot smoking. Scientists from Harvard and Northwestern observed an altered amygdala and nucleus accumbens (associated with fear, aggression, paranoia and addiction) in study participants.”

Some of the pathophysiological changes could include personality disorders, psychological disorders, anger, mood swings, psychosis and early onset schizophrenia.

Personality Changes

The NCBI performed a study in 2015, documenting the effects marijuana had on a user’s personality. The conclusion of the study stated:

“Marijuana use is associated with changes in impulse control and hostility in daily life. This may be one route by which deleterious effects of marijuana are observed for mental health and psychosocial functioning. Given the increasing prevalence of recreational marijuana use and the potential legalization in some states, further research on the potential consequences of marijuana use in young adults’ day-to-day life is warranted.”

Psychological Disorders

In 2014, the NCBI performed a study on the psychological effects of marijuana. The conclusion of the study stated:

“Our results support the widespread adverse effects of cannabis use on neurocognitive functioning. Although some of these adverse effects appear to attenuate with abstinence, past users’ neurocognitive functioning was consistently lower than non-users.”

Marijuana Addiction and Anger

Marijuana is known for its relaxing properties. Many people try marijuana to “chill out” or ease anxiety. Yet when someone begins to abuse marijuana, it can have an adverse effect.

For example, if someone uses marijuana at an inappropriate time (like before work, school or certain social situations), he or she may need to overcompensate to act “normal.” We know that marijuana can slow reaction times, which can become obvious to others. The user may overcompensate while trying to act sober and end up becoming frustrated or angry as a result.

Cannabis Addiction and Relationships

Marijuana can also have a negative effect on relationships. When someone becomes addicted to marijuana, it’s common for that person to create stronger bonds with people who uphold their delusions.

Many marijuana abusers start hanging out with other abusers and choose social settings based on whether marijuana will be involved. They might stop spending as much time with their other friends as a result.

Cannabis Addiction Mood Swings

Addiction can also cause mood swings — other than just feelings of anger. One way to determine if you or a loved one has an addiction is to take notice of sudden changes in mood.

The user may seem elated and happy one moment, then cranky and irritable the next.

Psychosis and Cannabis Addiction

There is some research that suggests that cannabis addiction can lead to psychosis. Users who abused the drug who were predisposed to psychotic disorders, such as bipolar disorder, were more likely to experience symptoms of the disorder.

Schizophrenia and Cannabis Addiction

Finally, marijuana abusers who were schizophrenic sometimes exhibited early onset symptoms of schizophrenia. Doctors believe that marijuana addiction can trigger schizophrenia. It’s important to note that these users would have experienced the symptoms of schizophrenia at some point in their lives — the marijuana abuse simply triggered the symptoms earlier than usual.

Positive Effects of Cannabis

It is important to note that many cannabis users report they have successfully used cannabis to treat certain psychological and mood disorders, such as anxiety and depression.

Yet according to a Forbes article, most of this research is anecdotal — not scientific.

Psychology Today reported similar findings in 2017 in an article entitled, ‘Medical Marijuana for PTSD?’ The studies on the effects of marijuana on psychological disorders are so new that it’s difficult to make a definitive conclusion one way or another. Yet the anecdotal evidence states that medical marijuana could be effective in treating PTSD victims.

Cannabis Addiction Treatments

There are three main treatments for cannabis addiction, according to the NIH: cognitive-behavioral therapy, contingency management and motivational enhancement therapy. There are two ways for users to quit: cold turkey and incrementally.

All these treatments and methods require support from family and friends. Let’s start by talking about the first steps in treating a cannabis addiction.

Recognizing the Problem With Cannabis

As most recovering addicts will tell you, the first step to recovery is recognizing you have a problem. If you don’t recognize your problem, you won’t be able to change your habits. If you are the family or friend of an addict, it’s important that person understand that drug abuse is a problem. Without that first step, it will be practically impossible for the user to quit.

If you need advice determining if your loved one has an addiction, this hotline is a great place to start. The volunteers can also help you determine the best course of action to help your loved one. If you feel you may have a marijuana addiction, you can also call for guidance.

Interventions for Cannabis Addiction

SAMSA can also help you stage an intervention for a loved one. Helping a loved one understand he or she has a problem isn’t easy. Your loved one might realize a problem exists, but often drug abusers are the last ones to “see” they have a problem.

A large layer of shame can surround any addiction, whether it’s alcohol, drugs, food or shopping. It’s important to tell your loved one that you simply care about his or her well-being — and give that person the space to accept the problem.

Luckily, unlike most drug addictions, marijuana addictions don’t typically end in death from overdose. It’s practically impossible to overdose on cannabis. Yet you want to try to help your loved ones as soon as possible because other areas of their lives can start to deteriorate.

According to the Mayo Clinic, the purpose of an intervention: “Provides specific examples of destructive behaviors and their impact on your loved one with the addiction and family and friends. Offers a prearranged treatment plan with clear steps, goals and guidelines. Spells out what each person will do if your loved one refuses to accept treatment.”

Denial of Cannabis Addiction

It’s common for cannabis abusers to deny they have a problem. It’s a common step in the road to recovery.

Cannabis Addiction Recovery Plan

Once your friend and family are onboard, it’s time to devise a plan. According to the American Addiction Centers, there are six steps to successfully quitting marijuana:

Pick a Date to Quit

Since marijuana users often incorporate using into their daily routines, it’s difficult to quit cold turkey. Choosing an arbitrary date can feel inconsequential. Instead, choose a date in the future, and consider this date your “cannabis-free birthday.”

Get Rid of Paraphernalia

You can’t use it if you don’t have the tools. Start getting rid of your bongs, rolling papers, pipes, cannabis cooking tools and vape pen now. Removing these visual reminders will help you focus on other aspects of your life.

Choose Cold Turkey or Tapering

Quitting cold turkey (immediately without weaning yourself off the drug) can be difficult. Yet some people find cold turkey more effective than tapering. Before going down one route or another, make the decision.

If you choose cold turkey, switching to tapering mid-stream will likely result in a relapse.

Decide on the “rules” for tapering. How often can you use cannabis per day while tapering? When will you use it? How long will tapering last? Stick to your plan.

Prepare for the Worst

No one wants to start a drug rehabilitation program thinking it “won’t work.” Yet the simple fact is that most people fail to quit. Failure is a part of quitting, and it’s important to have a plan to get back on track should that happen.

Pay Attention to Your Health

One of the most important reasons to quit marijuana (if you’re abusing it) is to stay healthy. You’ll need to replace your marijuana habit with a positive habit anyway. Why not choose a date to start running, yoga or dance classes?

Visit your doctor for a physical. It’s possible that your marijuana addiction created problems that you’ll want to address sooner rather than later.

Lifestyle Changes

Many marijuana addicts find themselves relapsing because they’ve made the drug such a huge part of their lives — they just can’t stop.

Some of the ways you can create healthy lifestyle changes to support your new, healthy habits are to re-evaluate your social circle and find support.

If your friends all use marijuana, you’re more likely to relapse. You don’t need to “dump” your entire group of friends to quit. But you may need to limit your time around the friends who use. You might even need to tell them about your decision to quit and only meet up with them in places where marijuana use is frowned upon.

Joining a support group can also be helpful. It’s likely that you don’t know many marijuana addicts (if any!).

Unfortunately, marijuana addiction is often scoffed upon. Since the brain doesn’t become chemically altered by marijuana in the same way that it would by cocaine or “harder” drugs, many people don’t see it as a legitimate addiction.

Joining a support group can help you find people who understand your struggle and your desire to live a fulfilling and healthy lifestyle.

You may also want to find a sponsor who you can call or text when you need support or feel the need to use.

Replace Cannabis With Good Habits

One final step is to replace cannabis with good habits. If you’re using cannabis as an escape for your problems or to curb stress, you’re going to find all those problems waiting for you once you quit. Before you quit using, start to incorporate good practices into your day.

If you use cannabis to relax, try meditating for a few minutes before using. If you don’t need the cannabis anymore, don’t use it. If you use it as an escape for your problems, start trying to face your issues before quitting. Sign up for a therapy app, like Talkspace. Buy a few self-help books on dealing with your issues.

If you’re addicted to marijuana, it’s probably partially because you weren’t dealing with certain stressors in your life. You’re more likely to relapse if you don’t have a plan to deal with those stressors in the future.

Cannabis Treatment Options

Three types of treatments are typically used to help marijuana abusers stop using it. They include cognitive-behavioral therapy, contingency management and motivational enhancement treatment.

Cognitive-Behavioral Therapy

According to Psychology Today, “Cognitive-behavioral therapy (CBT) is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors and thoughts. Unlike traditional Freudian psychoanalysis, which probes childhood wounds to get at the root causes of conflict, CBT focuses on solutions, encouraging patients to challenge distorted cognitions and change destructive patterns of behavior.”

Contingency Management

Contingency management therapy is a reward-based system for abstinence. The NIH reported that this method was effective with many types of dependency. Yet it’s inconclusive as to whether this type of treatment is effective long-term. The cost of this form of treatment can also be an issue because the cost of the rewards must be allocated into the price of the treatment.

Motivational Enhancement Therapy

According to the NIH, motivational enhancement therapy involves a series of motivational statements and affirmations.

“Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the patient. In subsequent sessions, the therapist monitors change, reviews cessation strategies being used, and continues to encourage commitment to change or sustained abstinence. Patients sometimes are encouraged to bring a significant other to sessions.”

Cannabis Dependence and Withdrawal

One of the most difficult aspects of dealing with cannabis dependence is dealing with withdrawal symptoms.

According to American Addiction Centers, cannabis withdrawal symptoms can include, “Feelings of anger, irritability, and/or aggressiveness; sensations of extreme nervousness or anxiety; disturbances with sleep that can include insomnia or very disturbing dreams and even nightmares; decrease in appetite that may or may not be associated with a significant loss of weight; feelings of restlessness and general malaise and the onset of feelings of depression.”

These symptoms can arise within a week of quitting and can last for up to a month. They are generally the worst at the 20-day mark.

Cannabis and Depression

One of the worst symptoms of cannabis withdrawal is depression. Many users who have a cannabis dependence relapse because of this symptom.

Desert Hope, a drug treatment facility in Las Vegas, suggests incorporating healthy activities into your day to deal with these symptoms.

Ultimately, remembering that you’re quitting for your health can be a great reminder of why you’re on the path to recovery. It’s also important to remember that this article is about cannabis addiction or dependency. The side effects and symptoms outlined here are not necessarily typical or experienced by those who use cannabis responsibly.

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